Miya Pearson
It can be distressing for parents to hear their newborn coughing while sleeping, but it is a common occurrence that can be caused by various factors. While it is usually not a cause for concern, there are instances where a persistent cough may indicate a more serious health issue. Understanding the different types of coughs and their potential causes can help parents identify when medical attention is required.
| Characteristics | Values |
|---|---|
| Reasons | Croup, asthma, allergies, teething, common cold, flu, choking, pneumonia, sinus infection, whooping cough, bronchiolitis, infant reflux, respiratory syncytial virus (RSV), COVID-19 |
| Age | Children younger than 4 months rarely cough. Coughing in children older than 1 year is usually not alarming. |
| Duration | Croup and common cold symptoms usually clear up in 3-4 days. |
| Time of Day | Coughs are often worse at night. |
| Sounds | Barking, wheezing, birdlike whooping, dry, raspy, scratchy |
| Accompanying Symptoms | Congestion, runny nose, fever, vomiting mucus, coughing fits, noisy harsh breathing, sore throat, sneezing, difficulty breathing, fast or erratic breathing, trouble inhaling, eczema, family history of asthma |
| Treatment | Cough medicine (for children older than 6 years), steam from the shower, bulb syringe or nasal aspirator, chest rub, extra fluids, warm drinks, chicken noodle soup, saline nasal drops, small spoonful of honey (for babies older than 12 months), steroids (for asthma and croup), inhaled medications like albuterol and inhaled corticosteroids |
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What You'll Learn
Asthma, croup, and other illnesses
Coughing is a natural part of life and a child's body will cough to protect itself and keep its airways clear. While most cases of babies coughing in their sleep are harmless and will clear up on their own, there are some instances when you should seek medical help. If your baby is coughing terribly in winter, it could be a sign of respiratory syncytial virus (RSV), a dangerous viral infection for infants.
If your baby is under 3 months of age, or when the cough is accompanied by a high fever or signs of breathing difficulty, do not wait to call your doctor or seek emergency care. A cough without any noise may indicate a complete obstruction and is a medical emergency.
If your baby is older than 1, coughs are less alarming, and they often signal nothing more than a cold. A baby's cough can also be caused by teething, which can cause excessive drooling and subsequent coughing. If your baby has a dry cough along with a stuffy nose, it could indicate a cold. A phlegmy cough in infants could be due to bronchiolitis, a lower tract respiratory infection often caused by viruses like RSV.
If your baby's cough sounds like a bark, it could be croup, which is when a portion of a child's upper airway becomes swollen, typically triggered by a virus. Croup usually affects children under the age of 5 and often begins with a normal cold or sniffle earlier in the day. It can usually be managed at home with warm, humidified air, a steamy shower, and other supportive measures. However, sometimes croup requires medical care and, rarely, severe cases might require hospitalisation.
Asthma is another common cause of coughing in children. Asthma coughs are often worse at night, as the steroid your body produces drops in the evening. If your child has asthma, make sure you have an asthma action plan from your doctor, including the right asthma medicines.
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Reflux and teething
Newborns can cough while sleeping due to various reasons, including:
- Asthma: Airways tend to be more sensitive and irritable at night, triggering coughing.
- Common cold: Mucus from the nose and sinuses can drain down the throat and cause coughing during sleep.
- Allergies: Allergens in the environment, such as dust or pet dander, can trigger coughing.
- Croup: A viral infection that affects children under five, often starting as a normal cold and progressing to a cough.
- Respiratory syncytial virus (RSV): A dangerous viral infection for infants that can cause coughing.
- Pneumonia: Can be caused by food entering the lungs and is characterised by a cough and high fever.
- Foreign object: A sudden coughing spell may be due to a foreign object stuck in the baby's throat.
If your baby's cough interferes with their sleep and healthy growth, it is important to consult a doctor. They will be able to determine the underlying cause and recommend appropriate treatment.
- Drooling: Excessive drooling can cause an upset stomach and increased spit-up.
- Gagging: The combination of teething and reflux can lead to gagging and congestion.
- Poor sleep: Teething and reflux can disrupt sleep patterns.
- Congestion: The production of extra saliva during teething can lead to congestion.
- Ear infections: In some cases, teething and reflux may contribute to ear infections.
To manage the discomfort of reflux and teething, non-medication teething treatments are recommended as a first line of defence. This includes:
- Rubbing the baby's gums with a clean, cool finger.
- Offering cold drinks or a cold-water-filled teething toy to chew on.
- Using a damp cloth or teething toys to soothe sore gums.
- Trying cold foods like yoghurt for babies over six months old.
If these measures are ineffective, doctors may recommend over-the-counter pain relief medication, especially if teething and reflux are interfering with the baby's sleep. However, it is important to note that pain relief medication can sometimes cause stomach discomfort, so it should be used cautiously.
In cases of severe reflux, prescription medications like H-2 blockers or proton pump inhibitors (PPIs) may be considered. These medications reduce or block acid production and are similar to those used to treat adult gastroesophageal reflux disorder (GERD). However, they may have potential side effects, including constipation, diarrhoea, and an increased risk of bone fracture.
Additionally, thickened feedings, where a small amount of infant cereal is added to breast milk or formula, can help reduce reflux. It is important to consult a paediatrician before introducing solids or thickening agents to the baby's diet.
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Allergies
Coughing in newborns is usually not a cause for concern, as it is a natural reflex that helps protect the airways in the throat and chest. However, persistent coughing while sleeping could indicate underlying allergies, especially if accompanied by other symptoms.
If your newborn is coughing due to allergies, it is important to identify and remove the allergens from their environment. Common allergens include dust, pet dander, and pollen. Using an air purifier in your newborn's room can help remove allergens from the air. You should also ensure that your newborn is taking their prescribed allergy medication, if any.
To help relieve your newborn's cough, you can try the following:
- Ensure your newborn is well-hydrated by offering them plenty of fluids throughout the day. Warm water or warm drinks can help soothe the throat and relieve congestion. However, avoid giving them citrus drinks like orange juice, as they can irritate the throat.
- Use a humidifier in their room to add moisture to the air, which can help with congestion and soothe the throat. However, be sure to clean the humidifier regularly to prevent the growth of mold.
- If your newborn is old enough, you can prop up their pillow to elevate their head, which aids in drainage and reduces post-nasal drip.
- Consult your pediatrician or a healthcare professional if you suspect your newborn's cough is allergy-related. They may recommend specific treatments or medications to manage the allergies and associated coughing.
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Choking hazards
Coughing is a common reflex in newborns and is usually not a cause for concern. However, it is important to monitor your newborn's breathing and be aware of any choking hazards, especially when they start eating solid foods.
As your baby starts eating solid foods and learns to chew and swallow, the risk of choking increases. Here are some tips to minimize choking hazards:
- Food preparation: Cut food into small pieces or mash it to make it easier for your baby to chew and swallow. Avoid serving hard, sticky, or crunchy foods that are difficult to chew, such as raw carrots or apples. Also, avoid small, round foods like grapes, cherry tomatoes, and berries, as they can be choking hazards. Instead, cut them into smaller pieces or mash them.
- Avoid high-risk foods: Stay away from foods that are commonly associated with choking, such as whole corn kernels, hot dogs, large chunks of meat, peanuts, and peanut butter. These foods can be difficult to chew and swallow, especially for a baby who is just starting solids.
- Supervision: Always supervise your baby during mealtimes. Ensure your baby sits up while eating and does not walk, crawl, or lie down with food in their mouth. It is important to keep a close eye on them as they explore new foods and textures.
- Foreign objects: Small toys and other objects can pose a choking hazard. Keep small objects out of your baby's reach and regularly check their mouth for any foreign objects, especially if you notice any coughing or wheezing.
- Symptoms of choking: Educate yourself on the symptoms of choking. If your baby is coughing suddenly or wheezing, they may have swallowed something that is blocking their airway. A cough without any noise may indicate a complete obstruction and is a medical emergency.
- Nasal suction: Before feeding, use nasal saline and a bulb syringe to suction your baby's nose. This helps clear nasal passages and reduces post-nasal drip, which can trigger coughing and interfere with breathing.
- Medical advice: Talk to your child's doctor or nurse to learn more about choking hazards and what to do in a choking emergency. They can provide specific guidance based on your baby's age and development.
Remember, it is always better to be cautious and seek medical advice if you are concerned about your baby's coughing or choking.
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Remedies and treatments
If your newborn is coughing while sleeping, it is important to first identify the cause of the cough. Coughing is a healthy and important reflex that helps protect the airways in the throat and chest. However, it can also be a symptom of a more serious condition.
- Common cold: Coughs and colds often go hand-in-hand. The mucus from the nose and sinuses can drain down the throat and trigger a cough during sleep. This is only a problem if the cough won't let your baby sleep. Other symptoms of a cold include a runny nose, watery eyes, sneezing, tiredness, a raised temperature, and sore throat. To help relieve the cough, you can use a nasal saline and bulb suction to clear your baby's nasal passages before they go to bed. You can also try a cool-mist humidifier in their bedroom, which may help with sleep. It is important to keep your baby hydrated, so offer cool beverages like juice. However, avoid soda or orange juice, as these can irritate a sore throat.
- Flu: A dry cough is symptomatic of the flu. Symptoms can resemble those of a cold but develop more rapidly and affect more than just the nose and throat. Children can also develop ear pain and often become less active. The same remedies as for a common cold can be applied.
- Allergies: Allergens and irritants such as food, dust, pet dander, and pollen can cause a lingering cough. Other symptoms include watery or stinging eyes, a runny nose, a sore and/or itchy throat, a rash, and sneezing. Allergies are unlikely to be accompanied by a fever. To help your baby, try to remove any potential allergens from their environment, such as strong odors, dust, or pet dander. Room air purifiers can also be helpful for removing allergens.
- Asthma: Asthma can trigger nighttime coughs because the airways tend to be more sensitive and irritable at night. If your baby coughs while trying to fall asleep, it could be due to asthma. Asthma coughs are often worse at night because the steroid your body produces drops in the evening. If your baby has asthma, ensure they are taking their prescribed inhaled medications, such as albuterol and inhaled corticosteroids. You can also try a cool-mist humidifier in their bedroom, but be aware that this may worsen symptoms for some children.
- Croup: Croup typically affects children under the age of 5 and often begins with a normal cold or sniffle earlier in the day. A cough from croup can start suddenly, often in the middle of the night, and is usually characterized as "barky" or "croupy." Most children with croup will also have stridor, which is a noisy, harsh breathing that happens when the child inhales. Croup should clear up in three to four days, but if it doesn't, consult your doctor. To help your baby breathe easier, run the shower, close the bathroom door, and let them inhale the steamy air. You can also try taking them outside if the weather is mild, as the damp air may help.
- Foreign object: If your baby starts coughing suddenly while eating or playing with small toys, they may have something stuck in their throat. Look in their mouth for any obvious obstructions, as they may be able to cough it out themselves. A cough without any noise may indicate a complete obstruction, which is a medical emergency.
- Respiratory syncytial virus (RSV): RSV is a dangerous viral infection for infants and can cause coughing, especially in the winter. Other symptoms include a stuffy nose and a slight fever at night. If you suspect RSV, consult your doctor immediately.
- Pneumonia: Coughs with a fever of 102°F (39°C) or higher, especially if the child is weak and breathing fast, can be a sign of pneumonia. This requires immediate medical attention.
- Reflux: Cough with reflux is usually chronic due to the consistent backward flow of stomach contents and acid. Some babies may grow out of reflux, while others may need medication or other treatments.
If you are concerned about your newborn's cough, it is always best to consult your pediatrician or healthcare provider for proper diagnosis and treatment.
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Frequently asked questions
Coughing in newborns is usually a natural defensive measure taken by the body to clear the airways. However, it can also be a symptom of illness. If your newborn is coughing while sleeping, it could be due to asthma, teething, a cold, or a viral infection such as respiratory syncytial virus (RSV) or COVID-19. If you are concerned about your newborn's coughing, seek medical attention or call your pediatrician.
Common causes of a newborn's cough include teething, a cold, allergies, asthma, or a viral infection. If your newborn's cough is accompanied by other symptoms such as congestion, a runny nose, or a fever, it is important to seek medical advice.
If your newborn's cough interferes with their sleep and healthy growth, you should consult a doctor. Other signs that may indicate a more serious condition include difficulty breathing, a persistent cough for more than three weeks, and a high fever. Seek immediate medical care if your newborn is coughing due to choking on small objects or food.
To relieve your newborn's cough, ensure they are well-hydrated and use a humidifier in their room. You can also try nasal suction with saline solution and bulb suction before bedtime to clear nasal passages and reduce post-nasal drip. Consult your pediatrician before administering any cough medicines or remedies.
